Nutritional Deficiencies

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Nutritional Deficiencies



Phrynoderma :
Deficiency of vitamin A or essential fatty acids leads tophrynoderma which manifests as asymptomatic hardfollicular papules on the extensor aspects of the knees,elbows, buttocks and less commonly on the other areas.Night-blindness, bitot'sspots, keratomalacia and generalized dryness of the skin may be associated.



Pellagra :
This discase manifests as increased sensitivity to sunlightand is caused by deficiency of nicotinic acid in the food,treatment with isonicotinic acid hydrazide or rarely as apart and parcel of Hartnup syndrome. The skin showsintense redness along with large brownish scales, sharplylimited to the sun-exposed areas. Redness of the tonguemay be associated. The patient may also have dysenteryand/or dementia.



Angular Stomatitis :
This is caused by deficiency of the vitamin B complexgroup especially riboflavine and/or pyridoxine. It manifestsas a proliferative growth with a fissure at the angles of themouth. The patient may also have inflammation withscaling and fissuring on both the lips called cheilitis, redswollen tongue called glossitis, inflammation of the buccalmucosa called stomatitis, and scaling and follicular keratosis on the nose and the naso-labial folds calleddysebaceda.



Acrodermatitis Enteropathica :
Deficiency of zinc, irrespective of whether it is causedbecause of inability to absorb zinc from the gastrointestinal tract (Type I), deficiency of zinc in the mother'smilk (Type ll) or due to artificial feeding (Type III) leadsto vesiculation and ulceration around the nose, mouth, analopening and the genitalia. Acral parts such as the handsand the feet are also involved. This is usually associatedwith diarrhoea which may precede or follow the cutaneouslesions. Depending upon the cause it may occur in the infants during breast feeding (Type II) or after weaning(Type I), or in adults following gastro-intestinal short-circuiting operations (Type III).

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